Ministry of Health and Sports The Republic of the Union of Myanmar Hospital Statistics Report 2017-18 Health Information Division, Department of Public Health In collaboration with Department of Medical Services Nay Pyi Taw, Myanmar www.mohs.gov.mm June 2020 Ministry of Health and Sports The Republic of the Union of Myanmar Hospital Statistics Report 2017-18 Health Information Division, Department of Public Health In collaboration with Department of Medical Services Nay Pyi Taw, Myanmar June 2020 PREFACE Contents Page Contents i List of Tables ii List of Figures v Introduction ix List of Abbreviations xi Summary xiii SECTION I HOSPITAL ADMINISTRATIVE STATISTICS 1 Part A Response Rate of Hospitals 1 2 Part B Hospital Services 5 3 Part C Assessment on Hospital Efficiency with 26 The Pabón Lasso technique 4 Part D Surgical Operations, Deliveries, Stillbirths and Abortions in Hospitals 40 SECTION II MORBIDITY AND MORTALITY STATISTICS 1 Part A Inpatient Morbidity and Mortality Statistics (A) Inpatient Morbidity and Mortality Patterns of Hospitals 49 (B) Morbidity and Mortality Statistics for Target Population 66 (C) Morbidity and Mortality Statistics of Specific Disease Groups 89 (D) Distribution of Disease Groups by Region/State (2018) 104 (E) Single Leading Causes of Hospitalization By Region and State 110 2 Part B Outpatients Morbidity Statistics 144 SECTION III PRIVATE HOSPITAL STATISTICS 151 SECTION IV PROPOSED ACTIONS FOR THE FUTURE 157 SECTION V ANNEXES 1 Hospital Administrative Indicators 159 2 Description of Chapters of ICD-10 160 i List of Tables Page Table (1) Reporting Status of Public Hospitals by the Number of Months Reported 1 (2009-2018) Table (2) Response Rate of Public Hospitals by Region and State (2017-2018) 4 Table (3) Hospital Service Indicators for Union (2009-2018) 5 Table (4) Availability and Utilization of hospital resources by Regions and States 9 (2017-2018) Table (5) Estimated Totals for Hospital Resources and Services by Type of Hospitals for 13 Union (2017-2018) Table (6) Hospitals in the desirable zone of Pabón Lasso graph which also had ≥ 90% bed 29 occupancy rate (2017-2018) Table (7) Number and Percent of Surgical Operations by Type of Hospitals (2016-2018) 40 Table (8) Number and Percent of Surgical Operations by Regions and States (2016-2018) 41 Table (9) Numbers and Percent of Deliveries, Live births, Stillbirths and Abortions by 45 Types of Hospital (2016-2018) Table (10) Number and Percent of Deliveries, Live births, Stillbirths and Abortions by 46 Regions & States (2016-2018) Table (11) Single Leading Causes of Morbidity by Sex & Duration of Stay for Union 56 (2017-2018) Table (12) Single Leading Causes of Mortality by Sex for Union (2017-2018) 58 Table (13) Single Leading causes of Morbidity for Union (2014-2018) 60 Table (14) Single Leading causes of Mortality for Union (2014-2018) 61 Table (15) Leading Grouped Causes of Morbidity for Union (2014-2018) 62 Table (16) Leading Grouped Causes of Mortality for Union (2014-2018) 63 Table (17) Distribution of Discharges and Deaths by Sex and Age Group for Union 64 (2017-2018) Table (18) Leading causes of Morbidity in Neonate (1-28 days) (2017-2018) 66 Table (19) Leading causes of Morbidity in under one year age group (2017-2018) 68 Table (20) Leading causes of Morbidity in under five year age group (2017-2018) 70 Table (21) Leading causes of Morbidity in adolescents (15-19 year age group) (2017-2018) 72 Table (22) Leading causes of Morbidity in Elderly (65 year and above age group) 74 (2017-2018) Table (23) Leading causes of Mortality in neonate (1-28 days) (2017-2018) 76 Table (24) Leading causes of Mortality in Under one age group (2017-2018) 78 Table (25) Leading causes of Mortality in under five age group (2017-2018) 80 Table (26) Leading causes of Mortality in adolescents (15-19 year age group) (2017-2018) 82 Table (27) Leading causes of Mortality in Elderly (65 year and above age group) (2017-2018) 84 ii Page Table (28) Causes of Maternal Mortality (2017-2018) 86 Table (29) Leading causes of Morbidity among Communicable Diseases in Male Patients 90 (2017&2018) Table (30) Leading causes of Morbidity among Communicable Diseases in Female Patients 90 (2017&2018) Table (31) Leading causes of Mortality among Communicable Diseases in Male Patients 91 (2017&2018) Table (32) Leading causes of Mortality among Communicable Diseases in Female Patients 91 (2017&2018) Table (33) Leading causes of Morbidity among Cardiovascular Diseases in Male Patients 92 (2017&2018) Table (34) Leading causes of Morbidity among Cardiovascular Diseases in Female Patients 93 (2017&2018) Table (35) Leading causes of Mortality among Cardiovascular Diseases in Male Patients 93 (2017&2018) Table (36) Leading causes of Mortality among Cardiovascular Diseases in Female Patients 94 (2017&2018) Table (37) Leading causes of Morbidity among Malignant Neoplasm in Male Patients 96 (2017&2018) Table (38) Leading causes of Morbidity among Malignant Neoplasm in Female Patients 96 (2017&2018) Table (39) Leading causes of Mortality among Malignant Neoplasm in Male Patients 97 (2017&2018) Table (40) Leading causes of Mortality among Malignant Neoplasm in Female Patients 97 (2017&2018) Table (41) Leading causes of Morbidity among Chronic Respiratory Diseases in Male 100 Patients (2017&2018) Table (42) Leading causes of Morbidity among Chronic Respiratory Diseases in Female 101 Patients (2017&2018) Table (43) Leading causes of Mortality among Chronic Respiratory Diseases in Male 101 Patients (2017&2018) Table (44) Leading causes of Mortality among Chronic Respiratory Diseases in Female 102 Patients (2017&2018) Table (45) Leading causes of Morbidity among Injury, poisoning and other consequences of 103 external causes in Male Patients (2017&2018) Table (46) Leading causes of Morbidity among Injury, poisoning and other consequences of 103 external causes in Female Patients (2017&2018) Table (47) Single Leading Causes of Hospitalization by Sex in Kachin State (2017-2018) 110 Table (48) Single Leading Causes of Hospitalization by Sex in Kayah State (2017-2018) 112 Table (49) Single Leading Causes of Hospitalization by Sex in Kayin State (2017-2018) 114 Table (50) Single Leading Causes of Hospitalization by Sex in Chin State (2017-2018) 116 Table (51) Single Leading Causes of Hospitalization by Sex in Sagaing Region (2017-2018) 118 Table (52) Single Leading Causes of Hospitalization by Sex in Tanintharyi Region 120 (2017-2018) iii Page Table (53) Single Leading Causes of Hospitalization by Sex in Bago Region (2017-2018) 122 Table (54) Single Leading Causes of Hospitalization by Sex in Magway Region (2017-2018) 124 Table (55) Single Leading Causes of Hospitalization by Sex in Mandalay Region 126 (2017-2018) Table (56) Single Leading Causes of Hospitalization by Sex in Mon State (2017-2018) 128 Table (57) Single Leading Causes of Hospitalization by Sex in Rakhine State (2017-2018) 130 Table (58) Single Leading Causes of Hospitalization by Sex in Yangon Region (2017-2018) 132 Table (59) Single Leading Causes of Hospitalization by Sex in Shan State (Southern) 134 (2017-2018) Table (60) Single Leading Causes of Hospitalization by Sex in Shan State (Northern) (2017- 136 2018) Table (61) Single Leading Causes of Hospitalization by Sex in Shan State (Eastern) 138 (2017-2018) Table (62) Single Leading Causes of Hospitalization by Sex in Ayeyawady (2017-2018) 140 Table (63) Single Leading Causes of Hospitalization by Sex in Nay Pyi Taw (2017-2018) 142 Table (64) Single leading causes of outpatient morbidity statistics, (2017-2018) 144 [Summer Season] Table (65) Single leading causes of outpatient morbidity statistics, (2017-2018) 146 [Rainy Season] Table (66) Single leading causes of outpatient morbidity statistics, (2017-2018) 148 [Winter Season] Table (67) Reporting Status of the Private Hospitals by the Number of Months reported 152 (2018) Table (68) Single Leading Causes of Morbidity by Sex (2017-2018) (Private Hospitals) 153 Table (69) Single Leading Causes of Mortality by Sex (2017-2018) (Private Hospitals) 155 iv List of Figures Page Figure (1) Response Rate of Public Hospitals for Union (2009-2018) 2 Figure (2) Response Rate of Public Hospitals by Regions and States (2017-2018) 2 Figure (3) Trend of Hospital Resources for Union (2009-2018) 6 Figure (4) Distribution of Hospitals across Regions and States (2017-2018) 6 Figure (5) Distribution of Types of Hospitals by Regions and States (2018) 7 Figure (6) Percent Distribution of Types of Hospitals (2018) 7 Figure (7) Distribution of sanctioned beds and available beds by Regions and States 8 (2018) Figure (8) Trends of Bed Occupancy Rate (2009-2018) 17 Figure (9) Bed Occupancy Rate by Regions and States (2018) 17 Figure (10) Bed Occupancy Rate based on available beds by Type of Hospitals 18 (2017- 2018) Figure (11) Bed Occupancy Rate based on sanctioned beds by Type of Hospitals (2017- 18 2018) Figure (12) Trends of Hospital Performance (2009-2018) 19 Figure (13) Average turnover of patients per bed per year by Types of Hospitals 20 (2017-2018) Figure (14) Average turnover interval by Types of Hospitals (2017-2018) 20 Figure (15) Average duration of Stay by Types of Hospitals (2017-2018) 21 Figure (16) Hospital Performance by Regions and States (2018) 21 Figure (17) Utilization of Public Hospitals (Average No. of Inpatients & Outpatients per Day) 22 (2009-2018) Figure (18) Utilization of Public Hospitals by Type of Hospitals (2018) 22 Figure (19) Utilization of Public Hospitals by Regions and States (2018) 23 Figure (20) Outpatient attendances